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Plázár D, Meznerics FA, Pálla S, Anker P, Farkas K, Bánvölgyi A, Kiss N, Medvecz M. Dermoscopic Patterns of Genodermatoses: A Comprehensive Analysis. Biomedicines 2023; 11:2717. [PMID: 37893091 PMCID: PMC10604867 DOI: 10.3390/biomedicines11102717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: Genodermatoses are a clinically and genetically heterogenous group of inherited skin disorders. Diagnosing inherited skin diseases is a challenging task due to their rarity and diversity. Dermoscopy is a non-invasive, easily accessible, and rapid tool used in dermatology not only for diagnostic processes but also for monitoring therapeutic responses. Standardized terminologies have been published for its proper use, reproducibility, and comparability of dermoscopic terms. (2) Methods: Here, we aimed to investigate dermoscopic features in various genodermatoses by conducting a systematic review and comparing its results to our own findings, data of patients diagnosed with genodermatoses at the Department of Dermatology, Venereology and Dermatooncology, Semmelweis University. (3) Results: Our systematic search provided a total of 471 articles, of which 83 reported both descriptive and metaphoric dermoscopic terminologies of 14 genodermatoses. The literature data were then compared to the data of 119 patients with 14 genodermatoses diagnosed in our department. (4) Conclusion: Dermoscopy is a valuable tool in the diagnosis of genodermatoses, especially when symptoms are mild. To enable the use of dermoscopy as an auxiliary diagnostic method, existing standardized terminologies should be extended to more genodermatoses.
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Affiliation(s)
| | | | | | | | | | | | | | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Faculty of Medicine, Semmelweis University, 1085 Budapest, Hungary; (D.P.); (F.A.M.); (S.P.); (P.A.); (K.F.); (A.B.); (N.K.)
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2
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Letona-García NJ, Vasquez-Bonilla WO, Medina P, Porres-Paredes HS, Muñoz-Lara F. Síndrome de Brooke-Spiegler: una infrecuente enfermedad a tener en cuenta en la práctica dermatológica. BIONATURA 2022. [DOI: 10.21931/10.21931/rb/2022.07.03.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
El síndrome de Brooke-Spiegler (SBS) es una enfermedad autosómica dominante infrecuente, los pacientes con el SBS presentan mutaciones en el gen supresor tumoral CYLD, más frecuente en mujeres que hombres, entre la segunda y tercera década de la vida con una relación hombre:mujer de 1:6-9.6 y su incidencia exacta se desconoce. Clínicamente se presentan de manera simultánea cilindroma, tricoepiteliomas y espiroadenomas. Se presenta el caso de una paciente femenina de 64 años, quien consultó por aparición de masas en cabeza, tronco y las cuatro extremidades de 10 años de evolución, posteriormente aparecieron lesiones en cuero cabelludo, donde el crecimiento tuvo una evolución más lenta y que llegaron a ulcerarse; busca atención medica hasta que las lesiones iniciaron a ulcerarse, por lo cual fue referida al Hospital General San Juan de Dios de la Ciudad de Guatemala, al servicio de dermatología, donde se le realizó hematología completa, química sanguínea, tomografía computarizada de cráneo y biopsia incisional en sacabocados de 4 mm de piel de frente, mentón, región preauricular derecha y pierna derecha, el estudio histopatológico de las lesiones cutáneas en las regiones preauricular derecha y de frente reporto cilindroma, piel de mentón tricoepitelioma y piel de pierna derecha espiroadenoma. Con los hallazgos clínicos, estudios de imagen y hallazgos histopatológico se llega al diagnóstico de síndrome de Brooke-Spiegler. El tratamiento fue la prescripción cuidados de piel y derivación a cirugía plástica para tratamiento quirúrgico reconstructivo y seguimiento por la consulta externa de dermatología y cirugía plástica. La presencia de cilindromas, tricoepiteliomas y espiroadenomas hacen pensar en un síndrome de Brooke-Spiegler, que tienden a tener presentaciones muy sugestivas, como el tumor en turbante y desfiguración de la región de la cabeza. El abordaje es multidisciplinario, sin un tratamiento definitivo y seguimiento para evaluar las posibles conversiones a malignidad de las lesiones ulceradas.
Palabras claves: Cilindroma, CYLD, Espiroadenoma, Histopatología.
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Affiliation(s)
| | - Walter O. Vasquez-Bonilla
- Departamento de Patología. Hospital General San Juan de Dios, Guatemala, Guatemala Universidad Nacional Autónoma de Honduras (UNAH). Tegucigalpa, Honduras
| | - Pebbles Medina
- Departamento de Patología. Hospital General San Juan de Dios, Guatemala, Guatemala
| | | | - Fausto Muñoz-Lara
- Universidad Nacional Autónoma de Honduras (UNAH). Tegucigalpa, Hondura
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Nagy N, Dubois A, Szell M, Rajan N. Genetic Testing in CYLD Cutaneous Syndrome: An Update. APPLICATION OF CLINICAL GENETICS 2021; 14:427-444. [PMID: 34744449 PMCID: PMC8566010 DOI: 10.2147/tacg.s288274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/05/2021] [Indexed: 01/03/2023]
Abstract
CYLD cutaneous syndrome (CCS) is an inclusive label for the inherited skin adnexal tumour syndromes Brooke–Spiegler Syndrome (BSS-OMIM 605041), familial cylindromatosis (FC – OMIM 132700) and multiple familial trichoepitheliomas (MFT-OMIM 601606). All three syndromes arise due to germline pathogenic variants in CYLD, a tumour suppressor gene (OMIM 605018). CCS is transmitted in an autosomal dominant pattern, and has variable expressivity, both of the three syndromic phenotypes, and of the severity of tumour burden. Age-related penetrance figures are not precisely reported. The first tumours typically appear during puberty and progressively accumulate through adulthood. Penetrance is typically high, with equal numbers of males and females affected. Genetic testing is important for confirmation of the clinical diagnosis, genetic counselling and family planning, including preimplantation diagnosis. Additionally, identified CCS patients may be eligible for future clinical trials of non-surgical pre-emptive interventions that aim to prevent tumour growth. In this update, we review the clinical presentations of germline and mosaic CCS. An overview of the germline pathogenic variant spectrum of patients with CCS reveals more than 100 single nucleotide variants and small insertions and deletions in coding exons, most frequently resulting in predicted truncation. In addition, a minority of patients have large deletions involving the CYLD gene, intronic pathogenic variants that affect splicing, or inversions. We discuss germline and somatic testing approaches. Somatic testing of tumour tissue, relevant in mosaic CCS, can reveal recurrently detected pathogenic variants when two or more tumours are tested. This can influence genetic testing of children, who may inherit this as a germline variant, and inform genetic counselling and prenatal diagnosis. Finally, we discuss testing technologies that are currently used, their benefits and limitations, and future directions for genetic testing in CCS.
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Affiliation(s)
- Nikoletta Nagy
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Eotvos Lorand Research Network, University of Szeged, Szeged, Hungary
| | - Anna Dubois
- Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Marta Szell
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Eotvos Lorand Research Network, University of Szeged, Szeged, Hungary
| | - Neil Rajan
- Department of Dermatology, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.,Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, NE1 3BZ, UK
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Portincasa A, Cecchino L, Trecca EMC, Lembo F, Annacontini L, Ciancio F, Corsi F, Cassano M, Parisi D. A rare case of Brooke-Spiegler syndrome: integrated surgical treatment of multiple giant eccrine spiradenomas of the head and neck in a young girl. Int J Surg Case Rep 2018; 51:277-281. [PMID: 30241087 PMCID: PMC6146587 DOI: 10.1016/j.ijscr.2018.08.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/23/2018] [Accepted: 08/14/2018] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION The authors present a "four-step" integrated surgical protocol to treat a rare case of multiple giant eccrine spiradenoma (ES) of the head and neck in a young patient. PRESENTATION OF CASE An 18-year-old female patient presented with multiple swellings in the head and neck regions. The patient had a severe psychological trauma with a negative impact on her social life. Physical examination revealed multiple papulo-nodular swellings measuring between 5 cm × 8 cm and up to 10 cm × 20 cm in size with cerebriform aspect and soft consistency. Major lesions were located in the scalp, frontal area, neck, occipitotemporal, and retroauricular regions. Tissue biopsy found a benign composite adnexal neoplasm consisted in ES, trichoepithelioma, and cylindroma, a typical feature of Brooke-Spiegler Syndrome. A staged excision was planned, and available reconstructive options were considered. Scalp reconstruction included tissue expansions, advancement flaps, skin grafts, and dermal regeneration template (Integra®). All treatments were successful, and no recurrence was observed. The patient returned to a normal social life, and a radical excision with satisfying aesthetic results was achieved. DISCUSSION Although adnexal tumors are benign in most of the cases, these lesions are prone to arise in the craniofacial region, thereby causing aesthetic discomfort associated with pain, hemorrhage, and infection to the patient every day. Furthermore, there is a potential risk of malignant transformation. These concerns demonstrate the need to establish a surgical protocol for the treatment of adnexal tumors. CONCLUSIONS Our integrated surgical approach showed excellent aesthetic and functional results with benefits to the patient's life and complete oncological excision.
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Affiliation(s)
- A Portincasa
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - L Cecchino
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - E M C Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy.
| | - F Lembo
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - L Annacontini
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - F Ciancio
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
| | - F Corsi
- Department of Pathology, University Hospital of Foggia, Foggia, Italy
| | - M Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - D Parisi
- Department of Plastic and Reconstructive Surgery, University Hospital of Foggia, Foggia, Italy
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Verhoeft KR, Ngan HL, Lui VWY. The cylindromatosis ( CYLD) gene and head and neck tumorigenesis. CANCERS OF THE HEAD & NECK 2016; 1:10. [PMID: 31093340 PMCID: PMC6460526 DOI: 10.1186/s41199-016-0012-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/09/2016] [Indexed: 12/19/2022]
Abstract
Germline CYLD mutation is associated with the development of a rare inheritable syndrome, called the CYLD cutaneous syndrome. Patients with this syndrome are distinctly presented with multiple tumors in the head and neck region, which can grow in size and number over time. Some of these benign head and neck tumors can turn into malignancies in some individuals. CYLD has been identified to be the only tumor suppressor gene reported to be associated with this syndrome thus far. Here, we summarize all reported CYLD germline mutations associated with this syndrome, as well as the reported paired somatic CYLD mutations of the developed tumors. Interestingly, whole-exome sequencing (WES) studies of multiple cancer types also revealed CYLD mutations in many human malignancies, including head and neck cancers and several epithelial cancers. Currently, the role of CYLD mutations in head and neck carcinogenesis and other cancers is poorly defined. We hope that this timely review of recent findings on CYLD genetics and animal models for oncogenesis can provide important insights into the mechanism of head and neck tumorigenesis.
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Affiliation(s)
- Krista Roberta Verhoeft
- 1Department of Clinical Oncology, Li-Ka Shing Faculty of Medicine, the University of Hong Kong, Hongkong, SAR Hong Kong
| | - Hoi Lam Ngan
- 2School of Biomedical Sciences, Li-Ka Shing Faculty of Medicine, the University of Hong Kong, Hongkong, SAR Hong Kong
| | - Vivian Wai Yan Lui
- 3School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Hongkong, SAR Hong Kong
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